HomeMy Public PortalAbout9019 GARIBALDI AVE_Mechanical__ t
COUNTY OF LOS ANGE7.&9 TEMPLE CITY 0508 MECHANICAL PERMIT
DRPART?C= OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 0804300003
. B=ING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 ETT:
LEGAL ID: FEES PAID BUILDING ADDRESS:
TR: 5904 IT: 189 UN: .002 9019 GARIBALDI AV
FEE DESCRIPTION: QUANTI'T'Y: UGM: AMOUNT: TEMP CA 917801546
ASSESSOR INORIOMON NUMBER: NEAREST CROSS STREET: MYDA
5384-006-030 01 PERM= ISSUANCE FEE 27.75 THOMAS PAGEr 596 GRSD: H2 LOCALITY: TEIMPLE CITY, C
03 CO[MPR.4R 101 SOO KBTU 1.00 COM 52.20
TENANT: 09 FURNACE 101 500 KBTU 1.00 UNI 52.20 ISSUED ON: PROCESSED BY: PLAN BY: EZPIRRS ON:
30 AIR INLETS/OITTLa-r9 10.00 UNT 43.50 04/30/08 SR 10/27/08
41 VENTILATION FAN 3.00 FAN 47.25
OWNER: TEL. NO: TOTAL FEES 222.90 FINAL BY: CODE:
MANG, JAMES Q (626) 215-9510-
9019 GARTBArDI AV -"_T
TEMP 917801546
IIE9C82PT ON OF FARE
INSTALL AIR CONDITIONING AND ElE. TrNG SYSTEM
APPLICANT: TEL. NO:
WU (626) 524-3164-
4205 E. LIVE OAK AVE SPECIAL CONDITIONS:
ARCADIA, CA 91006
CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE
NA LU AND SHENG FANG (626) 286-3328-
5012 FA12= GROVE AVE #201 LIC. 190 FAU/XALL FURNACE
SAN GABRIEL, CA 91776 865781 B I
COMBUSTION ASR OPENI2NG9
7 ARCHITECT OR ENGINEAR: TEL. NO: DUCT WORK
MU, JACK (626) 524-3164-
4205 E. LIVE OAK AVE. LSC. NO: AC/COMPRESSOR
ARCADIA, CA 91006 C21951
THERl6D9 TAT
FIRE DAMPERS
SMOKE DETECTION DEVICES
COMMES?= HOOD
REPORT ID: DPR264 ROUTE TO: 890508
WORKERS' COMPENSATION DECLARATION APPLICATION FOR P E RM I T
I hereby affirm that I have a certificate of consent to self
Insure, or a certl1cate.'of'Wo{ken' Compensation Insurance, HEATING.- VENTILATING - AIR CONDITIONING
or a c.Ilf7ll d��co�pyy tthaF��"r" aeof'(SeC.�y 3600 Lab. C.) 76's-�
Policy N� M r' - 46 DPW 9/88 -
COUNTY OF LOS ANGELES BUILDING AND SAFETY
❑ Certified copy Is hereby furnished. ,
❑ Certified copy Is filed•wlth the county building Inspec- FOR APPLICANT TO FILL IN BUILDI
Hon department. (PRINT OR TYPE ONLY) ADDRB55 —
Date Applicant �? NO. TYPE OF APPLIANCE OR EQUIPMENT FEE 6
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE CROSS ST`
(This section need not be completed if the work Irrvolved by ABSORPTION UNIT, BTU DwRr-T t4a BY
the permlit is for one hundred dollms (;100) or Iep.) Q�
I certify that In the performance of the work for which this AIR FIANDUNG UNIT, CSM D
permit Is Issued, I shall not employ any person In any manner BOILER BTU
so as to become subject to the Workers'Comperuatlon Laws. �',, APPROVALS DATE s�GrNrnR>
Date A�nllcant COMPRESSOR, BTU` bqM ROUGH r
NOTICE TO APPLICANT: If,. after making this Certlflcate of VEJTILAT}ON SYSTEM FINAL
Exemption, you should become sublect_to the Workers I 2E
Comper}satlon.provisions of the Labor Code, you must forth- EVAPORATIVECOOLER V ATION
with comp)y with such provisions or this permit shall be deem-
ed revoked. FURNACE: FAU GRAVITY
LICENSED CONTRACTORS DECLARATION FLOOR BTU no
q�
I hereby affirm that I'am licensed under provisloru of Chapter 9 HEATER: SUSPENDED UNIT
(commencing with Section 7000)of Division 3 of the Business WALL
and Profess to ns Code;and my IIceMe Is In full force and effect.
CL
Ucense Number c..Clgss� , 0
O
Cohtroctorr rmagt 2 -Date- U
OC
O
❑ I am exempt under Sec.
Plan check fee W
B.BP.0 for Xftis reason CL
PERMIT ISSUING FEE $ _
Date: 1
TOTAL FEE
Signature im
OWNER-BUILDER DECLARATION PLAN CHEO(APPLICANT
I hereby affirm that I am exempt from the Contractors License ,
Law for the following reason (Section 7031.5, Business and ALA/JE
Professions Code):
ADDRESS A
I, as owner of the property, or my employees with
wageas their sole compensation,will do the work and C
s I
the structure Is not Intended or offered for sole (Section . CITY TEL NO. 7 49A1
7044, Buslnea and Professions Code). OWNER
I, as owner of the property, am exclusively contracting 1 ��
❑
with licensed contractors to construct the project (Sec- MAILT T �Q
tion 7044, Business and Professloru Code). ADDS
CONSTRUCTION LENDING AGENCY a7Y TEL NO. CWK 49■00
I hereby affirm that there Is a construction lending agency for
the performance of the work for which this permit Is Issued CONTRp,CTC>R , C •011
(Sec 3097, Ov. C_}
ADDRESS
Lenders Name - ry�-y-�_�y�y�
CITY TEL NO. LP1LR 1�JLAJ 1 f I JI7O
Lenders Address — 1670 - 1 AM 9.19
1 certify that I have read this application and state that the ACES NO UC_
above Information Is correct. I agree to comply with all County
ordlnances and State laws relating to building construction,
and hereby authorize representatives of this County to enter
u R the bov a Cloned grope Irupeirtlon purposes.
SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature of Appllrmnt Agent Date �s